AB1531 HANDS-ON JOINT ASPIRATION WORKSHOP FOR INTERNAL MEDICINE RESIDENTS USING THE KNEE MODEL
Authors: R. Kaler, P. Gonzalez, Y. Ahmadzadeh, N. Sukumaran, Z. Y. LI, K. Gilek-Seibert
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Arthrocentesis is a procedure defined as synovial fluid aspiration that has diagnostic and therapeutic value in both the outpatient and inpatient setting. As mentioned in our prior study, joint arthrocentesis is not an Accreditation Council for Graduate Medical Education (ACGME) procedural requirement for Internal Medicine (IM) residents in the United States. Thus, we started the Phase I of our study, evaluating our in-house IM residents on their confidence level in performing intra-articular injections. This study resulted in more than half of the residents not feeling comfortable in performing arthrocentesis and nearly 100% of them reporting interest in learning arthrocentesis.<sup>[1]</sup> We later designed and implemented a resident-oriented quality improvement arthrocentesis teaching series. <h3>Objectives</h3> To design an arthrocentesis quality improvement (QI) teaching series for IM residents at Roger Williams Medical Center (RWMC) and evaluate their hands-on procedural skills and post procedural workshop confidence level in arthrocentesis. <h3>Methods</h3> Pre-workshop arthrocentesis learning material, including procedural check list and video, were compiled by IM residents at RWMC. A Rheumatology fellow demonstrated a one-to-one practice session on the knee model and the IM residents were graded based on the thoroughness of the procedural checklist. Each resident completed a post-procedure survey based on this arthrocentesis workshop. <h3>Results</h3> A total of 20 IM residents participated in the knee arthrocentesis workshop. As noted in Table 1, 85% of the residents believed that the pre-session information was helpful in preparing them for the workshop. (Table 1) On the post-workshop survey, 100% of the residents either agreed or strongly agreed to feeling more comfortable with the knee arthrocentesis after the practice, and all (100%) were interested in participating in future knee aspirations. The overall performance on the procedural aspect was also impressive with 40% of residents being able to complete the workshop on the knee model successfully on their first attempt and 55% on their second attempt. (Figure 1) Based on the procedure checklist score in Figure 1, residents were most proficient in the post-procedure stage with 100% score meanwhile, least successful on the aspiration of synovial fluid stage with a score of 55%. <h3>Conclusion</h3> Our QI project has shown that a standardized lecture series on how to perform arthrocentesis has resulted in a significant improvement in the overall confidence of internal medicine residents. This should be taken into consideration and incorporated as part of the internal medicine learning curriculum. <h3>Reference</h3> [1]Gonzalez, P., &amp; Kaler, R., &amp; Sukumaran,N.,&amp; Eldib,A., &amp; Turkowski, Y., &amp;, Li, Z.Y.,&amp; Gilek-Seibert, K.. (2022, Jun). Most medicine residents would like to learn joint aspiration procedures but 2/3 have never done it: survey of community hospital trainees in Northeastern USA. Annals of Rheumatic Diseases, 81(DOI:10.1136), 1854-1855. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.